Schanler's article is excellent.  Dr. Schanler himself wishes we had a better
way to fortify human breast milk (perhaps with dehydrated human milk powder?)
for the protein, calcium and phosphorus preterm infants need.  The calories
can easily be supplied by hindmilk temporarily.  We don't, however, have any
idea what we are doing to an infant's long term metabolism or blood lipid
profile by LONG TERM use of hindmilk.  I wish we had a better product to use
now.  It is my clinical impression that when we add fortifiers, infants have
more residuals, abdominal distention, feeding problems, etc.  Research from
Dr. Scanler's unit does not agree.  Finally, Dr. Scanler and Paula Meier work
very closely together.
Nancy Wight MD, FAAP, IBCLC
Neonatologist